Method and apparatus for determining the amount of oxygen combined with the hemoglobin of blood



L 66 METHOD AND APPARATUS FOR DETERMINING THE AMOUNT OF OXYGEN COMBINED WITH THE H/EMOGLOBIN OF BLOOD Filed Jan. 17, L922 awwemtoz fafzzeZJ I ?atented Got. 28, 1924.

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' PALUEL J. FLAGG, 0F FLUSHING, NEW YORK.

mTHOD AND APPARATUS FOR DETERMINING THE AMOUNT OF OXYGEN COMBINED WITH THE HEMQGLOBIN OF BLOOD.

Application filed January 17, 1822. Serial No. 530,008.

To all'wlwm it m concern:

Be it 'known t at I, PALUEL J. FLAGG,

a citizen of the United States residing at Flushing, county of Queens, State of New York, have invented certain new and useful Improvements in Methods and Apparatus for Determining the Amount of Oxygen Combined with the Haemoglobin of B 00d, of which the following is a specification.

This invention relates to a method and apparatus for determining the amount of oxygen combined with the haemoglobin of the 'circulatin blood.

The invention provides a clinical method and apparatus whereby the amount of xyhaemoglobin in the circulating bloodm be determined, and further provides a ready and simple method of and an apparatus for making such determinatlon, and by! whlch approximately abcurate and quick results can be obtained. The invention is hence of great utility to physicians and surgeons in their practice, and is of particular value to surgeons or their assistants in aiding them to control the administration of anaesthetics during operations.

An embodiment of the apparatus of the present invention is shown in the accompanying drawings of which embodiment- Figure 1 is a perspective vieW.

Figure 2 is a top plan viewwith the cover removed.

Figure 3 is a top plan view of the color scale.

Figure 4 is a view in cross section.

In carrying out the present invention I first prepare a series of colored cards or indices corresponding. to the color of blood containing different amounts of oxyhaemoglobin, these cards or indices being deslgnated by the numerals 10, 11, 12, 13, 14, 15,

' 16, 17 on the accompanying drawing, and

these cards or indices 10 etc..are preferably mounted consecutively on a common mount, .being most convemently 1n the form of seg-:

ments mounted or printed on a round disk 30 which is conveniently rotatably mounted on a base 31, as indicated at 32, and the series is preferably! overlaid by a cover 35, having a windowor sight opening 38 therein, the window being preferably slightly smaller than the segmental color-cards or indices 10, etc. Between the color-card 30 and the cover 35 there is preferably arranged a disk 40, having portions 42, 40,

40 of difl'erent transparency, corresponding to the various tissues or covering overlying the blood capillaries such as the mucous membrane (40) the finger nail (40), skin (40") and a completely transparent portion (40, 40, 40') which may be segmental cut-out portions or openings in the said disk 40. The disk 40 is independently movable under the cover 35, so as to bring one or another of the difi'erential transparent portions 4O etc. into registry with the window 38 in the cover. A lug 40 may be provided on the disk 40 for manipulating it to bring the proper transparency into place under the window 38. In the form of embodiment shown, the color-disk 30 is pref- I ries on a light ground, as indicated at 41, 1

and these numbers are conveniently displayed through a separate window opening 43, simultaneously with the respective color segments. The numbers in the present instance represent percentages of oxygen unsaturation (oxygen loss) and the series are arranged in multi les of ten.

In preparing t e series of color cards, the extremes corresponding to complete saturation of the haemoglobin with oxygen (0) and complete cyanosis or unsaturation of the oxyhaemoglobin (100%).

The extremes of the scale are obtained as follows 1 A specimen of oxalatcd blood is exposed to an atmosphere .of pure oxygen until there is no further change in its color. The shade resulting is matched by a non-fading ink of a known formula. A portion of the same specimen is then exposed to an atmosphere of pure hydrogen until there is no further change in its color. This shade is also matched.

The first specimen yields a color represented by 0 unsaturation, the second specimen yields a color represented by 100% unsaturation. a

The orginal specimens are transported under air tightfconditionsto the laboratory l where careful quantitive determination of oxygen is made.Theheemoglobin,ot the nd specimen will be found unsaturated. Q

' I first specimen will be foundto'be saturated The haemoglobin of the. secwith oxygen.

to'be completely Intermediate. percentages I are, then ar- "rived at'by'weig'ht proportions of the two extremes.

of the scale and the actual unsaturation. is quantitively deterj I mined by the VanSlyke method. The read- 1 in'gs'ofithe s'caleand by analysis are made i to oo-inside; Inks of l known formulae, zcjor i responding in color, to the; shade of the blood 'having the determined percentage of oxygen, are then I used to. color the difierent "intermediate cards,and thesecards prefer ably are arranged in series, as' shown, I I

["To make a determination of the amount of oxygen or oxyhaemoglobin in the blood, i a comparison is directly made between the circulating blood of I the patient and. the

- the capil I series of'coloncards 'lO etseq; the percentage beingdirectly and immediately given by the number on the card which matches the g "circulating blood 'under'observation. The ginatching may be readily efi'ected'by turn 'ing the disk '30 hearing the color: cards','and

the circulating blood for the purpose ct matching may-be escaping from a: wound or blood beneath some tissue of the body, as beneath the mucous membrane of the lips, finger-nail, skin or the like, in which latter case, the differential transparency disk 40, would be turned until a segment or part L0 etc. corresponding to the transparency of the skin, nails, or other tissue or covering registers with the window 38.

The absorption of ox gen b the haemoglobin, resulting in oxy aemog obin, or the loss of oxygen by the oxyhaemoglobin resulting in haemoglobin (technically called reduced haemoglobin) as accomplished by a remarkable change in the mass color of the blood. Blood (haemoglobin) saturated with oxygen is of a brilliant brick red color. As the oxygen is gradually reduced, this shade gradually changes until with complete deoxidation, a deep mahogany color is seen.

Under normal conditions, the blood in the arteries is completely saturated with oxygen. As it passes through the capillaries into the veins it loses part of its, oxygen and in doing so changes its color. The amount of this change will depend upon the duration of its exposure to the tissues in contact with ary Walls. If the exposure is short, the change will be slight, if long, greater, up to a point where all the available oxygen will have been absorbed. Broadly speaking,

the duration of this, exposure and cons e quent' j j quality I breathed, the condition of the heart condition of the I blood vessels. A reduction in; the normal, quality or volume of the air breathedwill reduce the available oxygen. Abnormalities in the heartof @blood, vessels will delay itstransference.

spiratory organs caused by mechanical obstruction as during the unconsciousness of,

Therefore, abnormal conditions of the. re-

anaesthesia, or by disease,as pneumonia, abnormal conditions of the heart'as valvular disease, abnormal conditions of the blood absorption will depend upon the. of air breathed, the amount: of air l andthe I 1 vessels; as in mechanical I pressure, or in. the

capillary, stasis from superficial chilling, or 'f disease caused bychemlcals all results in; Q'varying degrees'ot deviation from thenon mal shade outshone-A. patient who suffers froma diminntion of; the normal. I oxyhaemoglobin'zis said to'be cyanosed I Gyanosis, heretofore, has merely conveyed anindistinct general idea of blueness from 3 loss of oxygen, technically spoken of as oxy I genunsaturation. It has also beenerrone- 'ously' attributed to an increase incarbon I .,dioxide. An absenceof oxyhaemoglobin is incompatible with life, and any deviation from complete saturation. is :an indication of an abnormalconditiomdue to disease or mechanical embarrassment. i To instruct an interne to keep his patient'free fromcyanosis' Q i I upon the: internes" conception of cyanosis. Therehasbeen no standard scale depends to instruct an interne not to allow more than 20, 30 or 4.0% unsaturation. To speak in terms of percentage is to speak definitely. Furthermore, it is an acknowledged fact that the constant observation of a color soon results in a loss of color perception for the particular color observed. It thus becomes essential to provide a known standard for comparison.

The most important sign in gas oxygen anaesthesia is the color sign and yet, no definite measure of this color scientifically based has ever been offered. By the present instrument normality is indicated at one extreme' and at the other, death.

The instrument is valuable in every operating room, to the nurse in the recovery room, to the surgeon who operates in the home, to the medical man who wishes a simple, rapid means of estimating the degree of oxygen unsaturation suffered by his pneumonia or heart cases, and to the clinician who wishes to dia ose mediastinal tumors or capillary stasis f r dm any cause.

To the research worker it provides a simpler means of determining preliminary oxygen readings without recourse to involved methods of quantitive analysis.

It is also of value commercially to the portrait painter and may even be used in a ous color divisions ascertained by quantitative chemical determination.

2. A method of measuring the oxyhaemoglobin content of the. circulating blood by comparing the blood with a standard color scale having indicia giving the values of oxyhaemoglobin unsaturation for the various color divisions ascertained by quantitative chemical determination, and laying over'said color scale a transparency corresponding to the natural tissue covering said blood.

3. An apparatus for determining theamount of oxyhaemoglobin in the circulating blood comprising a color scale having color divisions and indicia giving the amount oi oxygen unsaturation in blood corresponding to the color of a division of said scale.

4. An apparatus for determining the amount of oxyhaemoglobin in the circulating blood, comprising a color scale having color divisions and indicia giving the amount of oxygen unsaturation corresponding to the color of a division of said scale, said divisions being mounted together consecutively.

5. An apparatus for determining the amount of oxyhaemoglobin in the circulating blood, comprising a color scale having color segments and indicia giving the amount of oxygen unsaturation corresponding to the color of said segments, said segments being mounted consecutively on a rotatable part.

6. An apparatus for determining the amount of oxyhaemoglobin in the circulating blood, comprising a color scale having color segments and indicia giving the amount of oxygen unsaturation corresponding to the color of said segments, said segments being mounted consecutively on a rotatable part, and a cover having a window therein for exposing one of said segments at a time.

two subscribing witnesses,

7 An apparatus for determining the. amount of oxyhzemoglobin in the circulating blood, comprising a color scale having color segments and indicia giving the amount of oxygen unsaturation corresponding to the color of said segments, said segments being mounted consecutively on a retatable part, and a cover having a window therein for exposing one of said segments at a time, said cover having a separate window therein for exposing the indicia corresponding to the respective segments.

8. An apparatus for determining the amount of oxyhaemoglobin in the blood, comprising a color scale having color segments and indicia giving the amount of oxygen unsaturation corresponding to the color of said segments, and a part having a trans-- parency corresponding to the tissue overlying the blood under, observation, adapted to be placed over a color segment.

9. An apparatus for determining the amount of oxyhaemoglobin in the circulating blood, comprising a color scale having color segments and indicia giving the amount of oxygen unsaturation corresponding to the color of said segments, said segments being mounted consecutively on a ro tatable part and a rotatable part having a series of transparencies corresponding} to the transparencies of various tissues overlying the blood, adapted to be placed over said color parts.

10. An apparatus for determining the I amount of oxyhaemoglobin in blood, comprising a base, a disk having a series of color segments thereon and having indicia thereon giving the amount of oxygen unsaturation in blood under observation corresponding to the color of said color segments,

a disk having a differential transparency corresponding to the transparency of various tissues overlying the blood, adapted tooverlie said color-scale and a cover having a window through which said one or another of said color segments is to be seen.

In testimony whereof, I have signed my name to this specification in the presence of this 11th day of January 1922.

PALUEL J FLAGG. Witnesses:

JOHN A. DoNneHY, E. M. YAHE. 

